The aim of this in vitro study was to compare parametrically the coronal seal ability over different periods of times of four restorative materials used to seal the pulpal access cavity after endodontic treatment. One hundred and thirty-five mandibular premolars were divided randomly into three time groups (1, 2 and 4 weeks), each of which was in turn divided into four subgroups. Each subgroup was restored using one of four restorative materials: Coltosol, glass ionomer cement (GIC), zinc phosphate (ZP) cement, or intermediate restorative material (IRM) cement. The root canals were prepared using the crown-down technique, and obturated using lateral condensation. Following placement of the restorative material, the samples were incubated in distilled water at 37 degrees C and were subjected to 50 thermocycles (0 +/- 4, 56 +/- 4C). After immersing in (2%) methylene blue dye for 24 h, teeth were longitudinally sectioned and examined under a stereomicroscope. The results showed that Coltosol and GIC cement were significantly superior in sealing ability to ZP and IRM cements (P < 0.05). There was no significant difference between GIC cement and Coltosol. Both Coltosol and GIC after 1 week were significantly better than 4 weeks. There was no significant difference in the seal ability at different time periods when ZP and IRM cements were used.
The aim of this study was to investigate and compare, radiographically and clinically, the impacts of calcium-silicate based-cement (CSBC), nano-hydroxyapatite and platelet-rich fibrin (PRF) as pulpotomy agents in permanent immature molars with incomplete root development. Sixty-three participants (63 permanent immature molars) were included in this study. The patients were randomly divided into three equal groups. Fast setting MTA (MM-MTA), nano-hydroxyapatite and platelet-rich fibrin were used as pulpotomy agents. The teeth were evaluated clinically and radiographically after 6 and 12 months by two blinded examiners. Apical closure and pulp canal obliteration percentages were recorded. The in vitro reaction of the tested materials after a 7-day immersion period of the different materials in phosphate-buffered solution was analyzed using scanning electron microscopy to associate the in vitro mineralization with in vivo pulp canal obliteration percentages. Data were analyzed using Chi-square and ANOVA tests (α = 0.05). No significant difference was found between the three tested groups in terms of clinical and radiographic success (p > 0.05). All cases demonstrated evidence of root growth, including complete apical closure or continued apical closure. At 12 months, complete apical closure was found among the MM-MTA group (50%), nano-hydroxyapatite group (55%) and platelet-rich fibrin group (60%) (p > 0.05). After 12 months, pulp canal obliteration was more observed in the MM-MTA and nano-hydroxyapatite groups than in the PRF group (p < 0.05). MM-MTA (auto-mixed), NHA (hand-mixed) and PRF (autologous) could be used as pulpotomy agents since they exhibit comparable high clinical and radiographic success rates. However, the fact that the groups managed with MM-MTA and NHA have a higher tendency to canal obliteration might indicate that PRF should be considered the first choice material as pulpotomy agent, as it would make retreatment considerably easier.
Objectives Preserving the primary teeth is important, as they play an important role in the integrity of the dental arch, the development of the craniofacial complex, speech, and chewing. This study aimed to evaluate the effectiveness of both Mineral Trioxide Aggregate (MTA) and Bioceramic putty in primary molar pulpotomy with symptoms of irreversible pulpitis. Materials and Methods In this study, 40 s primary mandibular molars in 40 healthy children aged 6−8 years were examined and classified into 2 groups according to the material: group A, with 20 primary molars capped by MTA, and group B, with 20 teeth capped by Bioceramic putty. Clinical and radiographic evaluation of the treatment results was carried out after 1 week, 3 months, 6 months, 9 months, and 1 year. Results Clinical and radiological success rates in the MTA group reached 95%, where a case of failure was observed after a year of follow‐up. In the Bioceramic group, the success rate reached 100% after a year of follow‐up, without any statistically significant differences between groups ( p = .311). Conclusions Pulpotomy using biocompatibility materials (MTA‐Bioceramic) in primary molars with symptoms of irreversible pulpitis is considered effective due to the better advantages of the use of Bioceramic over MTA. This clinical trial was approved by Australian New Zealand Clinical Trials (12621001631897).
Introduction: Maintaining a vital pulp of immature permanent teeth is an essential and important requirement for dentin formation. Every effort must be made to preserve the vitality of teeth with incomplete apices to maintain the physiological apex generation process as much as possible. Pulpotomy is considered as one of the successful procedures to maintain this process in immature teeth. Aim: To evaluate the treatment success of pulpotomy of first immature molars with irreversible pulpitis using Platelet-Rich Fibrin (PRF) or Mineral Trioxide Aggregate (MTA) and monitoring the teeth for one year. Materials and Methods: A randomised clinical and radiological double-blinded evaluation was conducted in the Department of Paediatric Dentistry at Damascus University, Damascus, Syria. The research sample consisted of 24 first permanent immature molars in 20 children between age group of 6-8 years. Each of them had at least one first permanent immature molar with irreversible pulpitis. The research sample was randomly divided into two equal groups according to the treatment method: 1) pulpotomy with PRF; and 2) pulpotomy using MTA. Treatment were evaluated through periodic reviews and clinical and radiological examinations of the treated teeth by three specialists to assess treatment success. The treatment outcome was determined in terms of success or failure during two study periods (after six months and after one year). McNemar’s and Chi-square tests were applied using IBM SPSS version 20.0. The significance level was set at p-value <0.05. Results: Chi-square test showed that there were no statistically significant differences in the treatment success or failure between the treatment groups after six months and one year follow-up, p>0.05. After analysing the results statistically using McNemar’s test, it was observed that the treatment success rate after one year (50%, n=6) was lesser than that after six months (100%, n=12) in the MTA treatment group (p=0.031). In the treatment group using PRF, no significant difference (p=0.125) was observed in the success or failure of treatment between the two studied time periods (after six months and one year). Overall, the success rate of MTA was slightly higher than the success rate of PRF at the two study time periods (after six months and one year), the difference however was not statistically significant. Conclusion: Performing first immature molar pulpotomy using MTA had a slightly higher success rate than PRF pulpotomy.
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